As many as one half million women die each year from complications of labor. One of the common causes of these deaths is from obstructed labor. Of the women who experience obstructed labor, and who don't die, many develop a condition known as obstetric fistula. An obstetric fistula is an opening or hole that forms between the bladder and/or rectum and the vagina, after a prolonged labor, causing the woman to become incontinent. It is estimated that there are 2-4 million existing cases of obstetric fistula currently, and there are 150,000 new cases of this condition each year. This is a problem in developing countries all over the world, including South and Central America, Africa, the Middle East, and Southeast Asia. Obstetric fistula usually occur in two groups of women. The most common are young girls who are married when they reach puberty or before, are generally small in stature, malnourished and have little or no access to health care. In this group obstetric fistula occurs in their first pregnancy. The second most common population is in older women who have had many children, with each successive infant becoming larger. Or, she may have entangled twins or congenital malformations, such that the infant(s) are too large to be delivered without surgery. These women may have underlying conditions such as diabetes, which can cause infants to grow unusually large, or “macrosomic”.
In both of these cases, there is a disproportion between the size of the infants head, and the opening of the bony pelvis, making it impossible for the infant to be delivered. Once the uterus has begun contracting, it will continue to contract until its contents are expelled. In some cases a prolonged obstructed labor may last up to a week, during which time the woman will suffer excruciating pain and her infant will die. The labor contractions push the infants head against the bladder or rectum and the bony pelvis, depriving the tissue of blood and causing the tissue to die, this will form an opening between the vagina, bladder and/or rectum. After the woman has delivered her dead infant, she will find that urine or stool or both are pouring out of her uncontrollably through the passageway in her vagina.
The foul odor leads to severe stigmatization for various reasons. Females who develop obstetric fistula often are rejected by their husbands. Their incontinence and pain render them unable to perform household chores and further child rearing, thus devaluing their worth. They are often forced to leave their villages or live in isolated huts. If they do not die of infection or starvation, they may lie in fetal position for years, vainly attempting to control their incontinence. As a result of this, they may develop leg atrophy and muscle contractions leaving them unable to walk. The intense loneliness and shame can lead to clinical depression and suicide.
Many societies do not believe obstructed labor, which leads to obstetric fistula, is a medical condition, but rather a divine punishment or curse for disloyal, disrespectful or unfaithful behavior. There are multiple dangerous and sometimes lethal traditional medicine cures for this condition. These include sitting on the woman, attempting to cut (often with unsterile knives or glass) the “webs” inside of her vagina which spirits have formed, making her confess her sins, or drink dangerous potions—all to no avail. Because this condition is not understood to be a medical condition, often medical treatment is not sought, even if it is available. All of these injuries could be prevented with basic access to maternal health care and cesarean sections. The United States had many patients with obstetric fistula until the early 1900's when cesarean section surgeries began being performed. In fact, what once was the main fistula hospital in New York City is now the Waldorf Historia.
High levels of poverty and low levels of education among women and their communities in developing countries, lead to serious maternal health issues, including lifelong injuries and death. A lack of basic knowledge of anatomy and some of the causes of obstructed labor, as well as limited access to health care, are conditions that lead to obstetric fistulas, with the resulting devastating consequences.
Therefore a need exists for pregnancy education dolls to teach the causes of obstructed labor and the causes of obstetric fistulas resulting from obstructed labor. These three dolls show both normal anatomy and examples of disproportion, (in both very young girls and in older women), between the size of the infant's head and the opening of the bony pelvis, thus making it impossible to deliver.
The relevant prior art includes the following references:
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